Vertical Rectus Muscle Transposition for Correcting Abduction Deficiency in Duane's Syndrome Type 1 and Sixth Nerve Palsy

Yazdian, Ziaeddin; Yazdian, Mohammad Ali; Rajabi, Mohammad Taher; Akbari, Mohammad Reza

doi:10.3928/01913913-20100308-07

Cited by 31 publications

(16 citation statements)

References 20 publications

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“…These findings were consistent with reported rates in the literature. [4][5][6][7][8] However, 96% of patients had fissure-narrowing/globe retraction on adduction, which was higher than reported rates in the literature. [9][10][11][12][13] The majority of our patients were classified as Duane group I (56%) followed by group III (28%) and group II (16%).…”

Section: Discussionmentioning

confidence: 66%

“…[4][5][6][7][8]14,15 In our surgical subset of 18 patients (14 type I and 4 type II), the majority had an excellent surgical outcome with significant improvements in AHP and FPP alignment.…”

Section: Discussionmentioning

confidence: 77%

“…We observed similar improvements in ET, head posture, abduction limitation, and abnormal head posture in comparison with 3 studies in which a vertical rectus muscle transposition was performed in the respective patient populations. 5,6,8 Another small study reported improved ET, head turn, and globe retraction after partial vertical rectus muscle augmented transposition and lateral rectus recession in 4 patients. 15 In conclusion, we believe that using a classification of DS based on FPP alignment can simplify the surgical management of these patients.…”

Section: Discussionmentioning

confidence: 99%

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Duane syndrome: Clinical features and surgical management

Kalevar

Tone

Flanders

2015

Canadian Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Duane syndrome: Clinical features and surgical management

Kalevar

Tone

Flanders

2015

Canadian Journal of Ophthalmology

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“…3 In Yazdian et al, only 3 of 62 patients had induced vertical deviations. 22 But other studies have reported a larger percentage, with larger deviations ranging from 8.5% with deviations larger than 8Δ in Ruth et al on patients with Duane syndrome, to 20%–40% in abducens palsy. 8,18,23,24 As in our patient who developed a recurrent vertical deviation, Phamonvaechavan et al reported on the number of patients with vertical deviations increasing at the 6–10 week postoperative visit.…”

Section: Discussionmentioning

confidence: 87%

Adjustable Augmented Rectus Muscle Transposition Surgery with or Without Ciliary Vessel Sparing for Abduction Deficiencies

et al. 2014

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Background Vertical rectus transposition (VRT) is useful in abduction deficiencies. Posterior fixation sutures enhance the effect of VRT, but usually preclude the use of adjustable sutures. Augmentation of VRT by resection of the transposed muscles allows for an adjustable technique that can reduce induced vertical deviations and overcorrections. Methods We retrospectively reviewed the records of all patients undergoing adjustable partial or full tendon VRT augmented by resection of the transposed muscles. Ciliary vessels were preserved in most of the patients by either splitting the transposed muscle or by dragging the transposed muscle without disrupting the muscle insertion. Results Seven patients with abducens palsy and one with esotropic Duane syndrome were included. Both vertical rectus muscles were symmetrically resected by 3–5 mm. Preoperative central gaze esotropia of 30.6 ± 12.9Δ (range, 17–50Δ) decreased to 10.6 ± 8.8Δ (range, 0–25Δ) at the final visit (p = 0.003). Three patients required postoperative adjustment by recession of one of the transposed muscles due to an induced vertical deviation (mean 9.3Δ reduced to 0Δ), coupled with overcorrection (mean exotropia 11.3Δ reduced to 0 in two patients and exophoria 2Δ in one patient). At the final follow-up visit 3.8 ± 2.6 months postoperatively, one patient had a vertical deviation <4Δ, and none had overcorrection or anterior segment ischemia. Three patients required further surgery for recurrent esotropia. Conclusions Augmentation of VRT by resection of the transposed muscles can be performed with adjustable sutures and vessel-sparing technique. This allows for postoperative control of overcorrections and induced vertical deviations as well as less risk of anterior segment ischemia.

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“…Rosenbaum [6] reported improvement in abduction from −3.9 to −2.8 after augmented transposition of the vertical rectus muscles in 42 patients with unilateral DRS, and-3.7 to −2.6 after non-augmented transposition of the vertical rectus muscles in 22 patients with unilateral DRS. Yazdian et al [7] improved abduction limitation from −4.00 ± 0.23 to −2.11 ± 0.48 after augmented transposition of the vertical rectus muscles in 38 patients with type 1 DRS. Britt et al [8] reported −2.5 to −4.0 abduction limitation after partial vertical rectus muscle transposition with augmented suture in 5 patients with DRS.…”

Section: Discussionmentioning

confidence: 99%

Postoperative full abduction in a patient of Duane retraction syndrome without an abducens nerve: a case report

Kim

Hwang

2017

BMC Ophthalmol

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BackgroundDuane retraction syndrome (DRS) consists of abduction deficit, globe retraction and upshoots or downshoots with adduction. The abducens nerve on the affected side is absent in type 1 DRS. After bilateral medial rectus muscle recession in unilateral type 1 DRS may improve the abduction limitation, but still more than −3 limitation remains.Case presentationA 6-month-old boy presented with esotropia which had been noticed in early infancy. He showed limited abduction, fissure narrowing on attempted adduction and a small upshoot OS. Left abducens nerve was not identified on magnetic resonance imaging compatible with Duane retraction syndrome type 1. He showed full abduction after bilateral medial rectus recession of 6.0 mm at the age of 9 months, and remained orthotropia with full abduction OU 2 years postoperatively. He is my only patient with Duane retraction syndrome who showed full abduction after bilateral medial rectus recession.ConclusionsA patient with the type 1 Duane retraction syndrome rarely may show full abduction after bilateral medial rectus recession mimicking infantile esotropia.

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Vertical Rectus Muscle Transposition for Correcting Abduction Deficiency in Duane's Syndrome Type 1 and Sixth Nerve Palsy

Abstract: The Scott Foster procedure is effective for improving deviation, abduction deficiency, and face turn in patients with Duane's syndrome type 1 and especially in those with sixth nerve palsy.

Cited by 31 publications

References 20 publications

Duane syndrome: Clinical features and surgical management

Duane syndrome: Clinical features and surgical management

Adjustable Augmented Rectus Muscle Transposition Surgery with or Without Ciliary Vessel Sparing for Abduction Deficiencies

Postoperative full abduction in a patient of Duane retraction syndrome without an abducens nerve: a case report

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